Maternal and infant mortality in West Africa… Beyond the numbers

By Clem Ugorji
THE pain of childbirth has been described as equivalent to 20 bones getting fractured at a time, a level slightly greater than the 45 del (a subjective measure of pain) limit of pain a human can endure. With this unique experience comes inexplicable joy and the pain is momentarily forgotten. But not in all cases. The curtains may fall on the mother or baby or both, and the long 9-month wait ends in anguish with a psychological pain that can never be quantified, not in words or numbers.

*Centre is the Executive Director NHIS, Dr. Waziri Dogo-Mohammed and some of the beneficiaries of the Maternal and Child project of NHIS/MDGs

Maternal and newborn mortality ratios, that is, the rates at which women or babies die from birth related complications, in West Africa are among the highest in the world. UNICEF reports that the maternal and newborn mortality rates in the West and Central Africa region are 679 women per 100,000 live births and 31 babies per 1000 births, respectively. This is in sharp contrast to the global average of 216 women and 16 babies. In Nigeria, the statistics are even higher, at 814 women and 34.1 newborns respectively (UNICEF 2018 Report). In 2016, Nigeria accounted for 9% of newborn deaths globally, behind only India and Pakistan, according to UNICEF. The statistics for maternal mortality are worse; in 2015, 19% of women who died during child birth in the world were in Nigeria, with the country being regarded as one of the most dangerous countries in the world for childbirth (Joint Maternal Mortality Report by WHO, UNICEF, UNFPA, World Bank Group, and the United Nations Population Division).

About 80% of the major causes of newborn deaths- complications related to preterm birth and low-birth-weight, infections such as sepsis or pneumonia and asphyxia (lack of oxygen at birth) -are preventable. The same goes for maternal deaths, which are mostly caused by sepsis, obstetric haemorrhage or bleeding, unsafe abortion, obstructed labour and pre-eclampsia complications. In the presence of skilled medical personnel and with access to healthcare facilities during pregnancy and at the time of birth, these numbers will reduce significantly. Unfortunately, in most parts of West Africa, these essentials are available to a small percentage.

In remote areas of the region, where majority of the births that make up these statistics occur, there are limited healthcare facilities and skilled birth attendants. Pregnant women in those areas complain about the cost of treatment, the distance of the health facility and attendant transportation costs, as well as, the unavailability of medical personnel and equipment during visits. Only slightly above one-third of births in the country are attended by doctors, nurses, or midwives; the rest takes place at home or in traditional birthing centres, where complications cannot be managed, leaving the statistics on newborn deaths uncaptured, in most cases.

These newborns and women are not just statistics. There is value in every human life, but more so children. They add beauty to our world- their innocence, their hopes and dreams. They form the very foundation on which we build our society. They provide the fresh canvas on which we can repaint the future of our nation. In these neonatal mortality statistics, we could have lost the scientist who would invent a cure for cancer, the President we yearn for, and more; individuals with boundless potentials before their lives are cut short. Undoubtedly, maternal and newborn deaths affect all of us and we cannot begin to quantify their impact.

This unacceptable situation is one of the many societal challenges that governments alone cannot effectively address. It is therefore encouraging that stakeholders at global and local levels, including many private sector players, are standing up to be counted in the fight against maternal and newborn deaths. At Coca-Cola, we are fostering partnerships with some governments across the West Africa region to improve the status quo. The Safe Birth Initiative (SBI), our new community Wellbeing programme to support efforts by national governments to reduce the alarming numbers of women and newborns who die from birth related complications every day, is one more investment through which we are determined to make a difference in our communities and help make the SDGs a reality.

This initiative is being piloted in Nigeria and Ivory Coast. In Nigeria, it is implemented as a strategic golden triangle partnership involving Coca-Cola, the Government (the Federal Ministry of Health and the Office of the Senior Special Assistant to the President on Sustainable Development Goals) and an NGO, Medshare International Inc. With a focus on promoting safe birth through strengthening the capacity of our hospitals, the Safe Birth Initiative will support the government in three key areas to help doctors and nurses in target public hospitals to minimise maternal and newborn deaths: providing vital maternal and neonatal medical equipment and supplies; training biomedical technicians/engineers to improve equipment maintenance and uptime; and reactivating abandoned medical equipment in hospitals which are wasting away at the expense of the precious lives of mother and babies for whom they were procured in the first place.

Over the next two years, the Safe Birth Initiative will focus on ten leading referral institutions comprising university teaching hospitals, federal medical centres and general hospitals across the country. Pregnancy gives life and should not take lives. We can all help to make this a reality in our communities, so that our mothers and babies come home alive.